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Administration Codes

Chandra Posted Mon 04th of June, 2012 20:37:48 PM

Dr uses Zofran 16MG - 15 min ( IVPB), Dexamethasone 10MG-15 min (IVPB), Fusilev 430 MG 2 hrs(IVPB), Benadryl 50MG IVP, Oxaliplatin 180MG, IVPB - 8 hours. Avastin 950 MG - IVPB 2 hrs, 5FU 2160MG - 22 hours - Please help with ADMIN codes.

SuperCoder Answered Tue 05th of June, 2012 14:53:34 PM

Hi Chandra Mohan,

We need additional info from your side.

1. start and stop times for each infusion?
2. was 5FU delivered by initiation of portable/implantable pump in MD's office?
3. 5FU 2160MG - 22 hours – Ask route of administration before putting any code

Chandra Posted Wed 13th of June, 2012 19:01:17 PM

Dr uses Zofran 16MG - 15 min ( IVPB), 12:30 PM to 12:45PM - PB - Piggyback
Dexamethasone 10MG-15 min (IVPB), 12:45PM to 1:00PM
Fusilev 430 MG 2 hrs(IVPB),1:00 Pm to 3:00PM
Benadryl 50MG IVP, IV Push 1 minute
Oxaliplatin 180MG, IVPB - 8 hours. 3PM to 10PM
Avastin 950 MG - IVPB 2 hrs, 10PM to 12:00 AM
5FU 2160MG - 22 hours - Please help with ADMIN codes. 12:00AM to 2:00AM Piggyback route

Please help with Admin codes.

SuperCoder Answered Thu 14th of June, 2012 19:01:12 PM

Based on the start times, we are guessing you are coding for a facility.Here's what we came up with based on the CPT guidelines for facility infusion coding:

1) IV CHEMO 3PM to 10PM Oxaliplatin 180MG, IVPB - 7 hours (originally said 7 hours, so please check time)
96413, Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug

96415x6, Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

2) IV CHEMO 10PM to 12:00 AM Avastin 950 MG - IVPB 2 hrs,
96417, Chemotherapy administration, intravenous infusion technique; each additional sequential infusion (different substance/drug), up to 1 hour (List separately in addition to code for primary procedure)

96415, Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

3) IV 1:00 Pm to 3:00PM Fusilev 430 MG 2 hrs (IVPB),
96367, Intravenous infusion, for therapy, prophylaxis, or diagnosis( specify substance or drug); additional sequential infusion of a new drug / substance, up to 1 hour (List separately in addition to code for primary procedure)

96366, Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

4) PUSH 12:30 PM to 12:45PM Zofran 16MG - 15 min (IVPB), - PB – Piggyback
96375, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)

5) PUSH 12:45PM to 1:00PM Dexamethasone 10MG-15 min (IVPB),
96375, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)

6) PUSH Benadryl 50MG IVP, IV Push 1 minute
96375, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)

Pump: 12:00AM to 2:00AM (22 hrs) CHEMO 5FU 2160MG - 22 hours –
96416, Chemotherapy administration, intravenous infusion technique; initiation of prolonged chemotherapy infusion (more than 8 hours), requiring use of a portable or implantable pump

Chandra Posted Mon 18th of June, 2012 20:01:39 PM

Thanks a lot for your timely help.

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